Usability testing of a multimedia e-learning resource for electrolyte and acid-base disorders

The usability of computer interfaces may have a major influence on learning. Design approaches that optimize usability are commonplace in the software development industry but are seldom used in the development of e-learning resources, especially in medical education. We conducted a usability evaluation of a multimedia resource for teaching electrolyte and acid-base disorders by studying the interaction of 15 medical doctors with the application. Most of the usability problems occurred in an interactive treatment simulation, which was completed successfully by only 20% of participants. A total of 27 distinct usability problems were detected, with 15 categorized as serious. No differences were observed with respect to usability problems detected by junior doctors as compared with more experienced colleagues. Problems were related to user information and feedback, the visual layout, match with the real world, error prevention and management, and consistency and standards. The resource was therefore unusable for many participants; this is in contrast to good scores previously reported for subjective user satisfaction. The findings suggest that the development of e-learning materials should follow an iterative design-and-test process that includes routine usability evaluation. User testing should include the study of objective measures and not rely only on self-reported measures of satisfaction.